Extracorporeal Life Support (ECLS) for Pulmonary Vein Stenosis Interventions

Pediatric pulmonary vein stenosis (PVS) is associated with high morbidity and mortality. We describe a case series of pediatric patients with advanced multivessel PVS who underwent cardiac catheterization with veno-arterial extracorporeal life support (VA-ECLS) to prevent cardiac arrest around high-risk pulmonary vein angioplasty and/or stent placement. VA-ECLS provided hemodynamic and respiratory stabilization, allowing completion of technically complex interventions in critically-ill pediatric patients who may not have otherwise tolerated catheterization. Using VA-ECLS in this setting requires a thorough assessment of risks versus benefits and specific patient criteria for consideration. This series highlights the potential role of VA-ECLS as an adjunctive strategy during high-risk catheter-based interventions for pediatric PVS to improve quality of life and lengthen lifespan.